Made available in DSpace on 2011-05-04T12:42:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / O presente estudo teve como principal propósito analisar o estado nutricional de gestantes adolescentes do Município do Rio de Janeiro, identificando características maternas associadas ao desfecho obstétrico peso ao nascer e validando um método para o diagnósticode ganho de peso gestacional. O desenho do estudo foi descritivo do tipo transversal desenvolvido com dados primários obtidos com o Estudo da Morbi-mortalidade e da Atenção Peri e Neonatal no MRJ, 1999-2001. A análise estatística foi dirigida a testar a hipótese de homogeneidade de proporções mediante análises bi e multivariada, com o uso de regressão logística multivariada e sua apresentação dividi-se em três artigos. O primeiro é uma revisão sistemática que visou a identificação de métodos de avaliação nutricional de gestantes adotados no Brasil e sua associação com desfechos obstétricos. / The main purpose of the current study is to analyze the nutritional state of pregnant adolescents in Rio de Janeiro, identifying maternal characteristics associated with the outcome of obstetric birth weight and validating a method for diagnosis of gestational weight gain. The design of the study was descriptive and cross sectional with the primary data obtained from “Study of Morbidity/Mortality and Care in Neonatal and Perinatal in the Municipal of Rio de Janeiro, 1999-2001.” Statistical analysis was aimed at testing the hypothesis of homogeneity of mean ratio by bi- and multivariate analysis – using multivariate logistic regression and its results are presented in this series of three articles. The first is a systematic review aimed at identification of methods of nutritional evaluation of pregnant women utilized in Brazil and its association with obstetric outcomes. There were 26 studies identified using the method recommended by Rosso(1985),the results demonstrate a serious discrepancy of literature, in quantity and quality, that contributes to evaluating the effectiveness of methods of anthropometric assessment of pregnant Brazilian women. The development of studies with methodological rigor in this area is needed and must address age differences as well as biological, socioeconomic and environmental factors of pregnant women. The second article aims to verify the association of maternal characteristics and the obstetric results of gestational weight gain among adolescent mothers in Rio de Janeiro. Included is a subsample of 703 adolescent mothers that carried full term. The results showed an association between the number of prenatal visits and weight gain during pregnancy, as well as an increase in the proportion of excessive weight gain amongst pregnant adolescents, particularly in the youngest adolescents. It concluded that the pre-natal consults improve quantity of weight gain but did not guarantee the quality of this gain, in particular for the younger adolescents. The quality of weight gain could have improved if pre natal nutritional care was valued and the recommendations utilized were geared torwards the specific nutritional standards for adolescents, from the beginning of the pregnancy. The third article assesses the performance of different methods of anthropometric evaluation of pregnant adolescents in predicting birth weight. The study was conducted with a subsample of 826 adolescent mothers. The evaluation of weight gain at the end of their pregnancy was assessed by following the recommendated method of the Institute of Medicine (IOM,1990;92), and adaptations of the MS (2006) following the recommended classification of pre-gestational BMI for adolescents (WHO,1995;2007) Low birth weight was defined as “less than 2500 grams” (WHO, 1995) for children born full term, “below the 10th percentile” for those born at less than 37 weeks of gestation, and a macrosomia as weight equal to or greater than 4000 grams. For small maternal stature a cutoff was used of falling below the 3rd percentile (WHO, 2007). Calculation of SE, E, VPP, VPN and the accuracy of the evaluation of gestational weight gain for the prediction of the BW. Given the growing epidemic of obesity in increasingly early age, the best option for assessment is the anthropometric pre-gestational nutritional method as recommended by WHO (2007), specifically for adolescents. This ensures a prediction of gestational weight gain within the internationally recommended ranges (IOM, 1990;92) and contributes to favorable outcomes, improving future prospects for the mother and child.